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Purpose We investigated the incidence of ocular surface disorders and determined predisposing factors in order to establish guidelines for eye care in intensive care unit patients in a Nigerian teaching hospital. Methods All unconscious and critically ill patients were investigated. Data included duration of sedation, muscle relaxants and mechanical ventilation and presence of organ failure. The eyes were examined daily and the eyelid position noted. Results Fifty-six patients were studied. 31 patients (55.4%.) developed OSD. The duration of sedation (4.06 vs 1.80 days) and ventilation (4.55 vs 1.62 days) as well as severity of illness significantly influenced the development of OSD, but the position of the eyelids did not. Patients who received saline irrigation were more likely to develop OSD (p=0.02). Conclusion ICU patients in our institution frequently develop OSD. There is a need to develop strict eye care guidelines for especially in the setting of organ failure.